ASSESSMENT OF METABOLIC PARAMETERS AND RENAL FUNCTION AS PROGNOSTIC FACTORS IN CARDIOVASCULAR DISORDERS IN HYPERTENSIVE PATIENTS: PP.35.474

Abstract

Objective: Usefulness of the assessment of metabolic and renal parameters in cardiovascular risk estimating in patients with hypertension. Design and Method: 58 hospitalized hypertensive patients, aged 29 to 83, were examined (20 women and 38 men). Patients were divided into two groups: A - without coronary artery disease (CAD) (28 patients) and B - with CAD (30 patients). Both groups were not significantly different in the level of systolic (SBP) [(A) 140+/−18 mmHg; (B) 139+/−15 mmHg] and diastolic (DBP) [(A) 88+/−13 mmHg; (B) 82+/−11 mmHg] blood pressure as well as in glomerular filtration rate (GFR) [(A) 78,57+/−24,25 ml/min/1,73m2; (B) 76,76+/−22,11 ml/min/1,73m2]. GFR was estimated according to MDRD formula. Both groups did not differ significantly in hypotensive and lipid lowering therapy. Following measurements were taken: blood pressure (BP), lipid profile and serum creatinine level. Echocardiography was performed in each patient, following parameters were measured in the end-diastolic phase: left ventricle diameter (LVd), right ventricle diameter (RVd), left atrium diameter (LAd), posterior wall thickness (PW) and intraventricular septum thickness (IVS); ejection fraction (EF) was assessed and left ventricle mass index (LVMI) was estimated according to Penn's formula. Results: We revealed statistically significant difference in the levels of total cholesterol [(A) 5,45+/−1,20 mmol/l, (B) 4,55+/−0,94 mmol/l; p = 0,0028] and LDL-cholesterol [(A) 3,47+/−1,03 mmol/l, (B) 2,63+/−0,77 mmol/l; p = 0,0009] between both groups. We also observed significant negative correlation between LVMI and GFR (r = -0,4820; p = 0,0081), LVMI and total cholesterol level (r=-0,3754; p = 0,0448) and LVMI and LDL-cholesterol level (r = -0,3771; p = 0,0438) in the group A. We observed significant positive correlation between GFR and EF (r = 0,4737; p = 0,0109) in the same group. None of these correlations was noticed in group B. Conclusions: 1) In patients with CAD cardiovascular complications are so advanced, that no direct relationship to the metabolic parameters and renal function may be seen. 2) Assessment of metabolic parameters and its influence on LVMI is of greater significance in patients with hypertension and without CAD in prevention of renal failure and CAD.